I'm not sure whether I believe adipose tissue is the only factor but it definitely plays a role.
DHT eats away at adipose tissue. And I believe I read a study saying it causes increased inflammation in adipose too.
Women and men with this condition generally have higher dht or dht conversion in scalp and often serum too.
I believe that this is at part induced environmentally not exclusive genetically as everyone claims. If you study the condition of obesity. You will see that it's characterized by inflamed hypoxic fat. Different people are different, and different fat tissue is different. So obviously this is not manifested the same in everyone.
There's a hate train on fat tissue but this may be partially misplaced. If fat tissue works properly it can help reduce the impact on other tissues. From excess lipids and I believe glucose. We have fat for a reason and it's function is complex.
I'm not fully sure the pathology since I don't have that much time to piece it together and research. But unhealthy fat causes inflammation like said for obesity. Increased fibrosis, hypertrophy and reduced angiogenesis. Which could be problems for hair growth and healthy tissue as it stops proper functioning. Studies show the exact factors in Androgenetic Alopecia pathology.
I'm assuming that similar principles apply and are found androgenic alopecia as well as other conditions.
At part because these conditions are all associated in studies. In the ones they are not. It may simply be that the condition had subsided at time of study. But I need to research this more.
Obese adipose has less vascularity, larger fat cell size, more inflammation, more fibrosis, hypoxia, higher apoptosis etc. thus not a healthy tissue. Healthy tissue is the opposite. Better vascularity, smaller cells, no hypoxia, adipose tissue is more insulin sensitivity able to secrete positive factors. There's endless studies on this. It's this very sensible that poor adipose creates poor growing environment. Which could ofcourse affect hair.
While there's genetic influences and differences. It's mostly environmentally induced, life style. Sedentary, high fat, high sugar.
High fat diet is a direct factor in obesity. And I believe high sugar diet has shown to increase DHT.
I'll be the most honest and admit that this was my diet for the last 10 years. And I'm surprised I haven't gone bald earlier and more aggressively looking back now. And things could've been different.
Another thing about high T and DHT. Is that they inhibit adipogenesis. The process of expanding fat. AND they increase collagen expression. While E increases elastin. Elastin causes more flexibility while collagen causes rigidity. Both are needed but too rigid and the tissue looses plasticity. And seizes to function properly.
I'm speculating that the increased dht causes inflammation, increased collagen expression. Chronic inflammation causes fibrosis. Increased collagen may be a substrate for that.
This lack of plasticity is not able to react to stimuli properly, causing insulin resistance and inability to properly cope with increased demands. Creating this cycle in Which the body reacts with increased dht.
Something similar may happen around the hair follicles. As the condition progresses so does fibrosis. And thus the inability to expand and flex properly. This leads to hypoxia. Which I believe further increases dht conversion as a response to the stress. This cycle builds up. And due to the difficulty of removing fibrosis. The fibrosis builds up and takes up space from the adipose, blood vessels and hair follicles. That's likely why it's hard to reverse this condition. Even if we can stop one of the main driving factors.
Obviously you guys already have this figured out to some extent.
Hence speculating ways to reduce this.
I still have to figure out the exact steps and ofcourse full causation.
I'd love to hear y'all thoughts.
adipeau.com
pubmed.ncbi.nlm.nih.gov
www.ncbi.nlm.nih.gov